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Nonthyroidal illness syndrome: evaluation of thyroid function in sick patients
Joanne E Langton1, Gregory A Brent
1Division of Endocrinology, Department of Medicine, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Los Angeles, CA, USA.
Endocrinology and Metabolism Clinics of North America
|June 12, 2002
Summary
Routine thyroid function tests in hospitalized patients are unreliable due to illness effects. Understanding these nonthyroidal illness impacts on thyroid tests is crucial for accurate diagnosis and treatment.
Area of Science:
- Endocrinology
- Clinical Chemistry
Background:
- Altered thyroid function tests due to illness are known but poorly understood.
- The clinical significance of these changes remains uncertain.
Purpose of the Study:
- To evaluate the reliability of thyroid function tests in hospitalized patients.
- To highlight the impact of nonthyroidal illness on various thyroid function assays.
Main Methods:
- Review of existing literature on thyroid function testing in illness.
- Analysis of how different thyroid function tests are affected by nonthyroidal illness.
Main Results:
- Thyroid function tests in hospitalized patients are less predictive of primary thyroid disease compared to ambulatory patients.
- Commonly used free T4 assays are significantly influenced by nonthyroidal illness.
Conclusions:
- Routine thyroid function testing in hospitalized patients should be discouraged.
- Clinicians must be aware of assay-specific influences of illness on thyroid function tests.
- Future research may lead to targeted therapies for nonthyroidal illness syndrome.